Quick notes about TMJ

Midday Escapades asked me about TMJ and so I thought I'd write a post detailing what I know about TMJ and what to do if you have it.

I have had TMJ for over 12 years now and if I could pin point it (which sadly I can't) I would have to say I got it way back when I was in high school and had my braces on. I had this orthodontist who gave me a retainer that when I bit down on it, it helps to close the gaps in my teeth faster. And I would do anything to make my braces come off faster. You would not believe the amount of time and energy my fifteen year old self spent clenching my teeth together.

TMJ Is defined as follows by TMJ association -
  • Temporomandibular Joint and Muscle Disorders (TMJDs), commonly called TMJ, are a collection of poorly understood conditions characterized by pain in the jaw and surrounding tissues and limitations in jaw movements. Injury and conditions that routinely affect other joints in the body, such as arthritis, also affect the temporomandibular joint. People diagnosed with TMJDs may be experiencing other symptoms and medical conditions as part of a broad multi-systems illnesses that go unrecognized.

It took me almost an entire two years to get my TMJ under control the first time I was able to find THE BEST specialist in the SW. I used everything in conjunction to be up to par. As long as it is manageable I am happy.  I wear my mouth splint (see below) every night without exception (I will admit paying $500 out of pocket helps motivate me too). I used anxiety medication which I was very wary about at first, but since stress was my main trigger it was a good decision. My TMJ dr also recommended a good pain management dr for trigger point injections. At one point I was having over 16 put in my neck and back every week. (very painful, but worth it) I mixed chiropractic care with massage and physical therapy. I used a TENS machine, heat and ice and lidocaine patches. All of this was done over the course of two years. Each in different waves, but it took over nine months to really start feeling normal good again. I journaled every day giving scales of how I felt pain-wise in all parts of my body, what meds I took, what I ate, etc. In order to keep my costs down, I did all my physical therapy at home. My specialist did everything he could to work with the insurance company to figure out ways to code it so I could have some of it covered. I also outsourced very little because when I did, I noticed almost immediately that the person was clueless. Most drs have heard about TMJ, most have read about it, but VERY FEW actually know what they are talking about. Most drs will make it worse. Get the best, it's SO worth it.

Sadly I got in a major car accident just six months after I was finally feeling better, but again with my pain management dr I was able to get back up to par in about four months.

Triggers for TMJ are as follows -
  • sugars - foods like carrots, corn
  • white flour - yes, switch to wheat or better yet, make your own foods; go gluten free if poss
  • stress - teeth clenching and/or grinding
  • accident creating the effect
Here's what I have learned in my extensive research and doctor visits.
  • Get the BEST TMJ specialist you can find
    • Do  your research here
    • then have them recommend a dentist, pain management (if nec) and physical therapist (again if nec)
  • Splint - have a mouth guard or splint made for your teeth 
    • do not have this made by the dentist; you'll probably have to pay out of pocket unless you
    • are one of the special people who live in a state where TMJ is considered a real diagnosis and covered my insurance
    • use denture cleaner to rinse it (baking soda is good too) and whenever I visit any kind of mouth dr I bring my splint and have them clean it
  •  Foods - the TMJ specialist will give you a meal plan with food to stay away from
    • certain foods will increase the pain and popping in the jaw
    • I knew a girl in college who opted for the jaw surgery where they sew your jaw shut. She chose to go completely sugar and flour free, making all her food from scratch.
    • cut your food up into smaller pieces; stay away from extremely gooey foods like peanut butter, carmel, gum; 
    • when I need sugar I usually drink apple juice because it gives me the feel of a major sweet, but it is still good for me though I am a sweets girl
  • Exercise & Posture
    • posture is very important to the functionality of your jaw. I had a physical therapist who taped large X's on my back with tape that required I sit up straight. Every time I tried to slouch it would pull.
    • Exercise is important. Stretching is key. Spend 10 minutes a day 2xs a day just stretching. Get some really good DVDs. I like Yoga for stress relief DVD. But I LOVE Michelle LeMay's Spirit Flow Rejuvenating Core Stretch. She is really good and I just love her DVDS. I would love to get more of her stuff.
  • Get a partner
    • If possible have someone close to you, who isn't afraid to move your neck in weird positions, come to your pain management appointments to learn how to stretch your body. This will lower your bills and help your progression because it will help you to do this more than just at your dr appt. 
I will tell you, though you should listen to your doctor, but I wouldn't recommend surgery simply because I have heard not great things, most important it may not help and it may actually create more pain. I think it depends on your type of TMJ.

TMJ is not a thing that can be fixed quickly or permanently. It is learning to LIVE WITH TMJ. It is being able to get TMJ under control and then keeping close watch on how your body is doing.

I can feel 100% and after one night of sleeping weird, I can put myself right back into a bad situation. It is very important to stay focused on how you are feeling, what is hurting and from where. You know your body best. Listen to it.

Please feel free to email me to discuss further at heavenisabookstore@gmail.com

The allergist

I went to the allergist for the second time.

The first time, I was really sick. I went because my general practitioner had sent me away telling me, "I would be fine." That was six weeks before I broke down and called an allergist. It had to be something. I couldn't function. I was tired, my eyes, nose and mouth were sore and swollen. My gland had been swollen like a golf ball for weeks.

We talked about my medications. She immediately told me to get rid of the Afrin. No more. It is very dangerous and could created holes in my nose and worse. Eww. Then she adjusted my medications. I am now on Singular because I have a small amount of asthma in the recesses of my lungs. She also gave me new nasal sprays - Veramyst and Astepro - each of them are used at different times of the day.

I was always told pills in the morning and nasal sprays at night because it is a more controlled environment for the sprays. But that was over a decade ago.

Now after another two weeks, I am much better. I still have allergy symptoms, but they are few and far between.

I find it funny that she said I had severe allergies with an underlying viral infection, yet my general physician did nothing for me. Sad.

So, this day was my second appointment with her. Today was skin testing. Finding out what I am really allergic to and what to do.

I go in and they sit me in a chair, put three pillows on my lap. They ask me to put my arms on top of the pillows and lay them inside up. Then they proceed to take a six prong (what looks like) a stamp that is resting in liquid and puncture my skin with it. Four on each arm. Which means I was punctured 48 times, with 48 different things I could be allergic to. Then the nurse says, "don't move, I'll be back in twenty minutes."

Haha, that's funny.

No really, that's what they do.

There was a little boy, I guessing about five years old, in a room down the way that was sobbing uncontrollable. I felt so bad. I could hear the nurses trying to console him. He wouldn't have it. My favorite -
"We are going to make you feel better, don't you want to feel better?"

Honestly, it didn't itch very badly except for the natural positive that they do so they can tell the allergy test is working. Until, they wiped all the test spots down with antiseptic. Once that air hit the spots, I wanted to scratch like a crazy woman, but I refrained.

This picture is called a positive.

Then once they narrowed down what I was allergic to, they then do an under the skin test on another part of my arm. They take the top allergies and put them each in a needle and poke them under the skin, quite like a tuberculosis test. It pops up the skin and THAT HURTS!! YEOWZA!!

I love this photo here because I was getting ready to leave and my allergist comes in and says, "Oh honey, wait, they will come in and clean you up so you don't scare anyone."

Haha. Forgot about the green marker, the pen marks and the rest spots. I probably did look like a walking disease.

I would really like to go back to have testing done for food allergies and chemical allergies. I am fully aware of the major chemical allergies that I have to most cleaning supplies, perfumes and dyes in lotions and soaps. It'd be great to know more about how to live my life more healthy and happy.

Post It Note Tuesday - the car

Better cat food, Whiskas

I used to serve my kitties Science Diet cat food because I felt it was the healthiest choice for my kitties. I want them to live long lives. Long healthy lives. Their food is one of the most important ways for me to show I care. They split a 6oz can of soft food in the morning and then they each get one (1/3cu) scoop of hard food. I personally am a fan of the smaller kibble size.

But one day I was shopping at Petsmart and it dawned on me that the .59 cents I used to pay for a can of food was now .87 cents. Then on another occasion it was now .95 cents. And at .98 cents I told myself I wasn't going to pay those prices. It was too expensive. Not to mention, I was throwing out at least half the can each day when they didn't eat it. I mean $1 per day not including the hard food I feed them.

I found a coupon in the newspaper for buy on get one half off for Whiskas soft food. They call them meal time trays. They sale for .59 cents and not only does Petsmart sell them, but so does Target. And if you've read my blog before you know I am a HUGE fan of Target.

One of the reasons I chose Whiskas is because it has been served in the vet offices that I have visited. So I know it can't be too bad for my cats.

But, at the same time MY CATS LOVE IT so I am starting to wonder if it's like fast food for cats. It can't possibly be that healthy if they eat it and (just about every day) lick their bowls clean. They wake me up in the morning, crying for me to feed them. They seem a bit more lively and a bit more rambunctious too.

On a busy work day, I can even put down their hard food (which is dinner) next to the soft, canned food and they will still finish the canned food too. I find them leaving the hard food left in their bowls. Whereas before they would leave the Science Diet canned food and then cry for more hard food.

Health wise, my cats need to eat their soft canned food. It provides nourishment in the form of juices and liquid. It helps my cats process their hair balls. It does add weight to them, but that is why they are not free fed and are on a strict (amount of food) diet. They only get one treat a day - though sometimes not even once a day. Usually when Izabel begs for a treat. Which is where I have heard is where most of the weight in pets comes from. I do not feed them table food, except on occasion of a piece of hamburger or steak.

So I wrote this post because I sometimes struggle with how to take care of my cats. I want the best for them, but sometimes I just cannot afford the best. I do what I can. And Whiskas works for me.

Martha I am not, but at least I'm trying

I got this crazy idea earlier this week to cook something.

And I don't mean throw some crap in the crock pot.

And I definitely didn't mean call Saint and ask him to throw something on the BBQ.

No I meant, pull out my Martha Stewart Cooking School book (thanks mom) and cook something that took time and preparation.

Which is code for eating after cussing and burning of the skin. My skin that is. Not the meat's.

After a day of pampering for my mom (pedicures and manicures, eyebrow waxing, lunch and Target) I got home, picked up the eight ton book and started flipping. Because it was after 3pm, closely rounding 3:30 I figured something quicker was more appropriate.

I chose Roasted Pork Loin with Pancetta and Sage (the recipe on Martha Stewart's website is a bit different than the one from my book) and sided with double baked potatoes (Saint's recipe). It sounded good and right up my alley - simple ingredients, few ingredients and enough work that I would feel accomplished.

When shopping, the store had all but butcher's twine which was okay because they ended up just giving me a good long piece of it for free. Whoot! Another reason why Martha is correct in saying "Making friends with your butcher is a good thing!"

The pork roast they had to choose from with either, over 5lbs or under 1.5lbs. Since there was only the two of us, I went for the smaller of the two. (and the cheaper) The pancetta was fun to locate because I had no idea what it was. I assumed it was some sort of bacon or similar to it, but the butcher cleared it up for me. (he was so helpful) I even filled out a guest comment card!

My biggest problem when cooking is figuring out how to make all the pieces come together at the same time. I usually end up with one item coming out, ready, about 15 minutes before the other(s). This time I tried to coordinate it, but didn't realize til later that the potatoes took about an hour to cook just to get ready to scoop and fill, then cook. (are you laughing yet?)

I sprinkled the meat with salt and pepper and then put it in the pan to sear all sides. It said brown all sides, but I wasn't sure exactly what brown meant til it started to really cook. Brown meaning: slightly brown? dark brown? different shades of brown? (but I was excited when it turned out to look brown)

I was trying so hard to make it look like the photos in the book that I cut the strings too short. After much cussing, I tied the strings together and then recut so they barely fit around the edges. (I had forgotten that my cut of meat was smaller by quite a bit) Thankfully, I am resourceful so I was able to make it work.

Once again, thanking mom, for her awesome pans that can go in the oven, I was pretty pleased that the pork loin looked like the picture. (close enough anyway after it had been beaten up a bit)

I then focused my attention to the potatoes that I pulled out of the oven and put in the microwave to cook a bit quicker. (again a mom trick) I cut each one in half, cutting off the top of the potato, scooping it into the bowl, then scooped out the inside of the half of potato and then mixing it with cheese, sour cream and half and half. (notice my mistake here? I didn't) Mixed, scooped back into the two halves and put in the oven for baking.

I checked the pork loin a few times, spooning the little bit of the juice on to the top. (seriously how did I end up with little to no juice in the bottom of my pan - it wasn't even at full med-high heat?) I burned my hand twice on the metal piece on the handle. OUCH!!

Mental note: buy more pot holders because holy cow the one I have isn't enough!! Also, very much appreciate the book and movie, Julie & Julia, because it is crazy hard to cook sometimes. (or all the time in my case)

First time I pulled out the potatoes to check the baking, Saint came over to observe and give the ever needed kisses of support and says, "where are the other halves of the potatoes?"

Me: "What other halves?"

then it dawned on me

Me: Oh crap, I cut it in half and then mixed it in, like deviled eggs. Oh crap, I don't do that with deviled eggs either. Since I had two potatoes, there should have been four halves. I had two. Heavily filled, I might add.

He smiled and I had to laugh.

This is so me and cooking. We don't go together so well, but I manage to keep a some-what healthy some-what distant relationship. Which I try so hard to limit the gap, but we have a bit of a low tolerance relationship.

After about twenty minutes of the pork loin cooking, I pulled it out to check the temperature to make sure it was good. It hit 130 degrees and then started to slow. I am silently praying it would hit the required 138 degrees. I turn around for two minutes and all of a sudden Saint starts telling me the temperature - 137, 140, 145 - and still rising.

Okay, it's done. Yes? Uhm, yes.

It requires 10 minutes to sit and . . . whatever it does for that time. So technically the meat was done with the potatoes.

They turned out yummy and despite the fact that I burned my hand three times - once badly enough to require neosporin and a little lovin' from Saint. (the man wanted to go out and get a gauze wrap to maintain my lovely hand)

Here's the Martha link for the recipe, but you should really get the book. Really. Seriously, I would love for a personal lesson from Martha. Course, she'd probably not survive.

Or it could be the funniest episode she's ever had.